Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2023; 29(19): 3003-3012
Published online May 21, 2023. doi: 10.3748/wjg.v29.i19.3003
Association of vitamin D and polymorphisms of its receptor with antiviral therapy in pregnant women with hepatitis B
Rui Wang, Xia Zhu, Xuan Zhang, Huan Liu, Yu-Lin Ji, Yong-Hua Chen
Rui Wang, Yong-Hua Chen, Division of Pancreatic Surgery, Department of General Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Xia Zhu, Huan Liu, Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Xuan Zhang, Yu-Lin Ji, Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wang R and Zhu X contributed equally to this work; Ji YL, Zhu X and Chen YH participated in design and oversight of the study; Zhu X, Zhang X and Liu H collected and study data; Wang R, Zhu X, Zhang X, Liu H, and Chen YH analyzed the data and wrote the manuscript; Zhu X, Ji YL and Chen YH revised the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Supported by the Key Research and Development Projects in Sichuan Province, No. 2021YFS0168; and the National Scientific and Technological Major Project for Infectious Diseases Control in China, No. 2018ZX10715-003.
Institutional review board statement: The study was reviewed approved by the Institutional Review Board of the West China Hospital, Sichuan University, approval No. 2019-151.
Informed consent statement: All study participants or their legal guardians provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Yong-Hua Chen, MD, PhD, Associate Professor, Division of Pancreatic Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China.
Received: February 17, 2023
Peer-review started: February 17, 2023
First decision: March 24, 2023
Revised: March 28, 2023
Accepted: April 24, 2023
Article in press: April 24, 2023
Published online: May 21, 2023
Research background

Mother-to-child transmission (MTCT) is the main route of hepatitis B virus (HBV) transmission, and HBV infection is associated with human vitamin D (VD) levels.

Research motivation

The role of VD and single nucleotide polymorphisms of the VD receptor gene (VDR SNPs) in blocking MTCT in pregnant women with high HBV viral load receiving antiviral therapy is unclear.

Research objectives

This study aimed to assess whether baseline VD levels and VDR SNPs are associated with the efficacy of tenofovir disoproxil fumarate (TDF) in the prevention of MTCT in pregnant women with high HBV viral loads.

Research methods

This retrospective study investigated VD levels, common clinical indicators, and virological parameters before and after antiviral therapy in 38 pregnant women with high HBV viral load, and further analyzed the effect of VD levels and VDR SNPs on the efficacy of TDF for the prevention of MTCT.

Research results

The present study showed that a high percentage (76.3%) of pregnant women with high HBV viral loads had deficient (< 20 ng/mL) or insufficient (≥ 20 but < 31 ng/mL) VD levels. There was a profound association between low serum 25-hydroxyvitamin D [25(OH)D] levels and higher levels of maternal HBV replication at delivery after TDF therapy. Multivariate logistic regression analysis showed that baseline serum 25(OH)D levels (OR = 1.23, 95%CI: 1.04-1.44), maternal VDR Cdx2 TT (OR = 0.09, 95%CI: 0.01-0.88) and cholesterol levels at delivery (OR = 0.39, 95%CI: 0.17-0.87) were associated with targeted antiviral effects (maternal HBV DNA levels < 2 × 105 at delivery).

Research conclusions

We demonstrate a significant association between low serum levels of 25(OH)D and high levels of HBV replication in pregnant women with high HBV viral loads, and maternal VD levels as well as VDR SNPs may be associated with the efficacy of antiviral therapy.

Research perspectives

Future studies to evaluate the therapeutic value of VD and its analogs in reducing the MTCT of HBV may be justified.